JP2001502572A - Device for fixing at least two vertebrae - Google Patents

Device for fixing at least two vertebrae

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Publication number
JP2001502572A
JP2001502572A JP10519033A JP51903398A JP2001502572A JP 2001502572 A JP2001502572 A JP 2001502572A JP 10519033 A JP10519033 A JP 10519033A JP 51903398 A JP51903398 A JP 51903398A JP 2001502572 A JP2001502572 A JP 2001502572A
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plate
anchors
vertebrae
legs
shape
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Inventor
ゲラン，ジャン
ロベール，ロジェ
トレムレ，ミシェル
ジュルダン，フィリップ
ガリ，フランソワ サン
グノー，ベルトラン
Original Assignee
ディピュイ フランス
ゲラン，ジャン
ロベール，ロジェ
トレムレ，ミシェル
ジュルダン，フィリップ
ガリ，フランソワ サン
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Publication of JP2001502572A publication Critical patent/JP2001502572A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7059—Cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0642—Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0641—Surgical staples, i.e. penetrating the tissue having at least three legs as part of one single body

Abstract

(57)【要約】 固定すべき椎骨内に予め形成された収容部内にほぼ垂直に導入でき、導入後は所定角度で互いの方向に折り曲って椎骨に一定の圧迫力を加えて完全に固定する１対のアンカー部（１ａ）（１ｂ）を各端部に有する少なくとも１つのプレート（１）から成る少なくとも２つの椎骨を固定する器具。 (57) [Summary] It can be introduced almost vertically into the preformed part in the vertebra to be fixed, and after introduction it bends in the direction of each other at a predetermined angle and applies a certain compressive force to the vertebra to completely fix it A device for fixing at least two vertebrae comprising at least one plate (1) having a pair of anchors (1a) (1b) at each end.

Description

【発明の詳細な説明】 少なくとも２つの椎骨を固定する器具 本発明は整形インプラント、特に脊椎のインプラントに関するものである。 ２つの椎骨間の頚部円板が変形すると、円板が滑り脊柱の神経根が圧迫されて 神経節に問題が起ることは知られている。この問題を克服するために種々のイン プラントが提案されている。これらのインプラントは問題となる椎骨の運動を固 定する場合とそうでない場合がある。 本発明は特に、椎骨の関節固定用インプラントに関するものである。 種々の解決策の中では、体内ケージ、頚部プロテーゼおよびプレートとネジと を用いた剛体な機械器具を挙げることができる。最後のものは固定する椎骨の前 表面にプレートを設置し、固定具がしっかりと定位置に保持されるようにプレー トを貫通して椎骨の一部にネジを螺合する。２つの椎骨の間には、これらの骨が 融合するまで間の機械的支持を確保するためのインプラント片が配置される。従 って、プレートはインプラント片を固定し、２つの椎骨を支柱する役目すなわち 剛体要素の役目をする。 しかし、この固定具の取付けはかなり複雑で、使用にはある程度の熟練を必要 とする。さらに、治癒時間を短くするためには融合期間中に一定の圧迫力を加え ておくことができない。 米国特許第５，３９５，３７２号には、嵌入時に一定の圧迫力が加わるように 適当に傾斜した、椎骨に嵌入される尖った分岐を備えた関節固定プレートが提案 されている。このプレートはネジで固定される。しかし、この解決法は十分なも のではない。 フランス国特許第２，６９４，６９６号には２つの分岐部とクロスピースとか らなる形状記憶材料で作られた骨固定用保持クランプが提案している。このクラ ンプでは分岐部が真っすぐに挿入され、その後、温度が体温を回復した時に変形 して圧迫力を加えるようになっている。 欧州特許第０，６４６，３５３号には形状記憶合金の変形によって互いに接近 可能な複数の分岐部からなる束ねたワイヤからなるクランプが提案されている。 しかし、このクランプはワイヤでできているため、圧迫力すなわち締付力が形状 記憶の製造工程に依存し、分岐部の復元力をコントロールするのが難しい。 本発明の目的はこれらの欠点を単純で信頼性があり、しかも有効で経済的な方 法で克服することにある。 本発明が解決しようとしてい問題は、問題となる椎骨間に一定の圧迫を加え且 つそれを維持（特に海綿状骨の領域において）することができる単一の小型要素 を用いて椎骨を関節固定することにある。 この小型要素は一般に脊柱前弯部の位置を維持するため前方から頚椎に固定さ れるが、ネジで固定しないと従来法のように簡単に抜けてしまう危険性がある。 本発明の目的は、脊柱前弯作用を低下させる生理的運動時でもネジのような補 助的保持手段を用いずにクランプを完全に保持できるようにすることにある。 この課題を解決するための本発明による少なくとも２つの椎骨を固定する器具 は、固定すべき椎骨内に予め形成された収容部内にほぼ垂直に導入でき、導入後 は所定角度で互いの方向に折り曲って椎骨に一定の圧迫力を加えて完全に固定す る１対のアンカー部を各端部に有する少なくとも１つのプレート（１）から成る ことを特徴としている。 プレートの取付けを容易にし、しかも、嵌入後に自動的に圧迫できるようにす るという課題を解決するために、各プレートおよびその固定部は正の温度では所 定の安定した形状をとり、負の温度では別の形状をとる形状記憶素材で作られる 。 アンカー部はほぼ０℃の時にほぼ垂直面内に配置され、ほぼ３７℃の正の温度 ではアンカー部は自動的に折れ曲がり、倒れる。プレートはアンカー部を垂直位 置に維持できる０℃の状態で保管される。 嵌入後にアンカー部の変形を可能にする課題を解決するため、各アンカー部は 対応するプレートの端部に、アンカー部を変形できるようにするため２つの所定 断面形状を有するノッチで区切られた中心接続部分を介して接続される。 各アンカー部は中心接続部分から成る共通の分岐部を介して端部の１方に接続 された２つの脚部から成るのが有利である。 プレートが体温に回復すると、中心接続部の周辺で脚部の形のアンカー部が弓 状面内で傾斜し、椎骨の海綿状骨に永久に圧迫力を加え、また、同じ中央接続部 にある２つの脚部はノッチの存在のために互いの方向に傾斜し、前面（より正確 には水平）に近い収束形に変形して、プレートが抜き出るのを防ぐ。 二対の固定脚部により加えられる２つの椎骨を互いに近付けようとする圧迫力 は同じ対の２つの脚部を一定の角度で互いに近付けようとする力より大きい値で 維持される。これは、中心接続部分が記憶効果を受ける材料をかなりの量有し、 一対の２つの脚部の接近は脚部が中心接続部分に接続する部分のノッチの領域の 材料の少ない量で決まることから容易に達成できる。 完全な固定をするという課題を解決するために、各脚部は内側に一連の歯のあ るスパイクを有する。 本発明の他の特徴は下記の点にある： a）プレートが椎骨の前表面にほぼ対応する横方向湾曲度を有する。 b）プレートが一つまたは複数の保持ネジと係合する少なくとも１つの溝孔を有 する。この溝孔は中心溝孔であるのが好ましく、円形であるのが有利である。プ レートを定位置に保持しておくために低温度時にプレートを支持する補助要素を 受けるように溝孔の内部はネジ込み、或いは形成する通路を形成することができ る。この通路は体内ケージまたは骨インプラント片または関節固定を行う他の素 材のようにスペーサー要素の挿入として用いることができる。２つの椎骨を中心 の椎骨の両側で接続するためのプレートでは中心椎骨にネジ込むネジを受けるた めの通路を用い、両端の椎骨を中間椎骨に押し付けて３つの椎骨を効果的に接続 することができる。 本発明のプレートは二対のアンカー部または脚部の間の中間部にプレート取付 け時に椎骨内空間を通し、関節の正中線の高さを維持する突起を有することがで きる。 以下、添付図面を参照して本発明をさらに詳細に説明する。 図１は温度０℃におけるプレート全体の斜視図。 図２は温度３７℃での図１に対応する斜視図。 図３は０℃の状態のプレートの平面図。 図４は図３に対応する側面図。 図５は３７℃の状態のプレートの平面図。 図６は図５に対応する側面図。 図７は本発明によって２つの椎骨を関節固定した場合の脊柱の一部の正面図。 図８は図７に対応する縦断面図。 既に述べたように、本発明が解決しようとしている課題は固定すべき椎骨（Ｖ １）および（Ｖ２）に一定の圧縮力を確保することにある。この目的を達成する ための本発明の固定器具は各端部に脚部（１ａ）（１ｂ）の形をしたアンカー部 を有するプレート（１）からなる小型の接続要素で構成される。このアンカー部 （１ａ）および（１ｂ）は椎骨（Ｖ１）（Ｖ２）に予め形成された収容部内に棘 状突起とは逆方向に係合するよう設計されている。 プレート（１）とそのアンカー部（１ａ）および（１ｂ）は形状記憶素材でで きており、約３７℃の正の温度では一定の安定した一つの形状をしており、それ より低い約０℃の温度では別の形状をとる。特に、約０℃の温度ではアンカー部 （１ａ）および（１ｂ）は実質的に垂直平面に来る（図１、３、４）。アンカー 部（１ａ）および（１ｂ）はこの状態で椎骨に予め形成した対応する収容部内に 導入できる。この収容部は椎骨に開けた孔にするのが好ましく、この孔の直径は 脚部が占める空間より大きくし、皮質骨で楔止されずに海綿状骨が完全に締付け できるようにするのが有利である。 ３７℃では、アンカー部（１ａ）および（１ｂ）は一定の角度で互いの方向に 自動的に曲がって（倒れて）、椎骨（Ｖ１）および（Ｖ２）に一定の圧迫力を加 え、プレート（１）を完全に固定する。それと同時に、同一対の２つの締付け用 脚部（１ａ）は、図５に示すように、互いの方向へ一定の角度で折れ曲がり、弓 状面内を移動する脚部による圧迫効果だけでなく、水平面内を移動して互いに接 近する脚部による締付け効果が加わり、全体として斜め移動することによってプ レートが抜けでるのが防止できるころは理解できよう。 温度が上昇した時に形状が変化できるようにするために、各アンカー部（１ａ ）および（１ｂ）は、２つの所定の断面形状を有するノッチ（１ｃ１）（１ｃ２ ）および（１ｄ１）（１ｄ２）で規定される中心接続部分（１ｃ）および（１ｄ ）を介してプレート（１）の端部に接続されている。各アンカー部（１ａ） （１ｂ）は中心接続部分（１ｃ）（１ｄ）と一体な共通分岐部（１ｅ）（１ｆ） を介して１つの端部に接続された２つの脚部（１ａ１）（１ａ２）および（１ｂ １）（１ｂ２）からなる。 各アンカー部の設計にあたっては、上記条件下での温度変化効果によって各脚 部（１ａ１）（１ａ２）および（１ｂ１）（１ｂ２）が正面内と弓状面内との両 面内で変形する（図２、５および６）ように設計する。前記条件下での各脚部の この変形によってプレート部分およびその端部部分の両方で圧迫でき、皮質骨お よび海綿状骨を接近させることができる。 固定用の脚部（１ａ，１ｂ）は、対応するノッチの端縁の一部を規定する材料 の橋部があるので、中心接続部分（１ｃ，１ｄ）から一定距離にある。この橋部 は同一対の２つの脚部、例えば正の温度になった時に脚部（１ａ）を互いに一定 の方向に近付ける変形力または変形値を調整するのに用いることができる。一般 に、同一対の２つの脚部間の望ましい締付け力は２対の脚部（１ａ）および（１ ｂ）を一定の角度で互いに接近させて椎骨同士を圧迫締付ける力より小さい。 各脚部（１ａ１）（１ａ２）および（１ｂ１）（１ｂ２）は先端が鈍く、内側 に一連のスパイク（１ｇ）を有している。プレート（１）は椎骨の前面の断面形 状にほぼ対応した横方向湾曲度と、頚部の脊柱前弯部に合った縦方向湾曲度とを 有している。プレート（１）の長さは固定する椎骨の数に依存する。 本発明の利点は上記の説明から明らかである。特に、温度上昇作用でアンカー 部が海綿状骨部分および皮質骨部分の両方で自動的に変形することによって一定 の圧力を維持することができる点が強調できる。 各プレートはアンカー部と一緒に０℃または負の温度でアンカー部を垂直位置 に維持できるような状態で保管される。プレートは４つの脚部（１ａ１）（１ａ ２）および（１ｂ１）（１ｂ２）を受ける４つの収容部材（ancillaire）を用い て容易に取付けすることができる。この収容部材は例えばネジ込みによって通路 または溝孔（１ｈ）に固定するのが有利である。 図１に表すように、プレート（１）には対を成す脚部間に突起部（１ｉ）を有 することができる。この突起は例えば長さ５ｍｍ、幅４ｍｍで、脚部に平行に延 び、プレート取付け時に２つの椎骨間に導入されて、一定の円板空間を維持し、 椎骨内円板を持ち上げる役目をする。 プレートは形状記憶特性によって変形可能な例えばめニッケルチタンからなる 一枚の金属板を切断、折曲げまたは型抜加工することによって単一部品として作 ることができる。DETAILED DESCRIPTION OF THE INVENTION                    Device for fixing at least two vertebrae   The present invention relates to orthopedic implants, in particular spinal implants.   When the cervical disc deforms between the two vertebrae, the disc slides and the nerve roots of the spine are compressed. It is known that problems occur in the ganglia. To overcome this problem, various in A plant has been proposed. These implants fix the vertebral movements in question. May or may not be specified.   The invention particularly relates to vertebra arthrodesis implants.   Among the various solutions are internal cages, cervical prostheses and plates and screws. Rigid mechanical devices using The last one is before the vertebra to fix Place the plate on the surface and play to ensure that the fixture is firmly in place. And screw a part of the vertebrae through. Between the two vertebrae, these bones An implant piece is placed to ensure mechanical support until fusion. Obedience Thus, the plate serves to fix the implant pieces and to support the two vertebrae, ie Acts as a rigid element.   However, the installation of this fixture is quite complicated and requires some skill to use And In addition, to shorten the healing time, apply a certain amount of pressure during the fusion period. I can't keep it.   U.S. Pat. No. 5,395,372 discloses that a certain pressing force is applied when it is fitted. Proposed articulating plate with appropriately inclined, pointed bifurcation to be inserted into vertebra Have been. This plate is fixed with screws. But this solution is not enough Not.   French Patent No. 2,694,696 describes two branches and a crosspiece. Bone fixation holding clamps made of a shape memory material have been proposed. This class In the pump, the bifurcation is inserted straight and then deforms when the temperature returns to body temperature To apply pressure.   European Patent No. 0,646,353 approaches each other by deformation of shape memory alloy Clamps consisting of bundled wires of possible branches have been proposed. However, since this clamp is made of wire, the compression force, that is, the tightening force It is difficult to control the restoring force of the branch part depending on the memory manufacturing process.   The purpose of the present invention is to make these disadvantages simple, reliable, effective and economical. Overcome by law.   The problem that the present invention seeks to solve is to apply a constant pressure between the vertebrae in question and Single small element that can maintain it (especially in the area of cancellous bone) To articulate the vertebrae using   This small element is generally secured to the cervical vertebra from the front to maintain the position of the lordosis. However, there is a danger that it will easily come off as in the conventional method unless it is fixed with screws.   An object of the present invention is to provide a screw-like supplement even during physiological exercise to reduce lordosis. The object of the present invention is to make it possible to completely hold the clamp without using auxiliary holding means.   Tool for fixing at least two vertebrae according to the invention to solve this problem Can be introduced almost vertically into a pre-formed receptacle in the vertebra to be fixed, Bends each other at a predetermined angle to apply a certain amount of compressive force to the vertebrae to completely fix it At least one plate (1) having a pair of anchors at each end. It is characterized by:   This makes it easy to mount the plate and automatically presses it after insertion. In order to solve the problem of Made of shape memory material that takes a certain stable shape and takes another shape at negative temperatures .   The anchor is located in a substantially vertical plane at about 0 ° C. and has a positive temperature of about 37 ° C. Then the anchor part bends automatically and falls down. Plate has vertical anchor Stored at 0 ° C where it can be maintained.   In order to solve the problem that allows the anchor section to be deformed after fitting, each anchor section is At the end of the corresponding plate, two predetermined They are connected via a central connecting part separated by a notch having a sectional shape.   Each anchor is connected to one of its ends via a common branch consisting of a central connection Advantageously, it consists of two legs which are adapted.   When the plate recovers to body temperature, the anchors in the form of legs are bowed around the central connection. Inclined in the plane of the vertebrae, permanently compresses the cancellous bone of the vertebrae and also has the same central connection The two legs at the front are inclined toward each other due to the presence of the notch, and The plate is deformed into a convergent shape that is close to horizontal) to prevent the plate from being pulled out.   Compression force applied by two pairs of fixed legs to bring two vertebrae closer together Is greater than the force trying to bring two legs of the same pair closer together at a certain angle. Will be maintained. This means that the central connection has a considerable amount of material that undergoes a memory effect, The approach of the pair of two legs is determined by the notch area where the legs connect to the central connection. It can be easily achieved because it is determined by a small amount of material.   Each leg has a series of teeth on the inside to solve the problem of perfect fixation. With spikes.   Other features of the present invention are as follows: a) The plate has a lateral curvature approximately corresponding to the anterior surface of the vertebra. b) the plate has at least one slot for engaging one or more retaining screws; I do. This slot is preferably a central slot, and is advantageously circular. Step Auxiliary elements to support the plate at low temperatures to keep the rate in place The inside of the slot can be screwed or formed to receive the passage You. This passage may be a body cage or bone implant or other element that It can be used as a spacer element insertion like a material. Around two vertebrae The plate for connecting on both sides of the vertebra receives a screw that screws into the central vertebra Three vertebrae are effectively connected by pressing the vertebrae on both ends against the middle vertebrae can do.   The plate of the present invention is attached to the intermediate portion between two pairs of anchors or legs. Through the intravertebral space during trauma to maintain the midline height of the joint. Wear.   Hereinafter, the present invention will be described in more detail with reference to the accompanying drawings.   FIG. 1 is a perspective view of the entire plate at a temperature of 0 ° C.   FIG. 2 is a perspective view corresponding to FIG. 1 at a temperature of 37 ° C.   FIG. 3 is a plan view of the plate at 0 ° C.   FIG. 4 is a side view corresponding to FIG.   FIG. 5 is a plan view of the plate at 37 ° C.   FIG. 6 is a side view corresponding to FIG. 5.   FIG. 7 is a front view of a part of the spine when two vertebrae are articulated according to the present invention.   FIG. 8 is a longitudinal sectional view corresponding to FIG.   As already mentioned, the problem to be solved by the present invention is that the vertebrae (V The purpose of the present invention is to secure a constant compression force in 1) and (V2). Achieve this goal Fixing device according to the invention for anchoring at each end in the form of legs (1a) (1b) It consists of a small connecting element consisting of a plate (1) having This anchor part (1a) and (1b) show spines in pre-formed receptacles in vertebrae (V1) and (V2). It is designed to engage in the opposite direction to the projection.   The plate (1) and its anchors (1a) and (1b) are made of shape memory material. At a positive temperature of about 37 ° C, it has a constant and stable shape. At a lower temperature of about 0 ° C. it takes another shape. In particular, at a temperature of about 0 ° C, the anchor part (1a) and (1b) are substantially in a vertical plane (FIGS. 1, 3, 4). anchor The parts (1a) and (1b) are now in the corresponding receptacles preformed in the vertebrae. Can be introduced. The receptacle is preferably a hole drilled in the vertebra, the diameter of this hole being Larger than the space occupied by the legs, the cancellous bone is completely tightened without being wedged by cortical bone Advantageously, it is possible.   At 37 ° C., the anchors (1a) and (1b) are oriented at a certain angle towards each other. It bends automatically (falls down) and exerts a constant pressure on the vertebrae (V1) and (V2). Then, completely fix the plate (1). At the same time, for two tightening of the same pair The legs (1a) are bent at a certain angle toward each other as shown in FIG. In addition to the compression effect of the legs moving in the plane, The tightening effect of the approaching legs is added, and the overall You can understand when the rate can be prevented from falling out.   In order to allow the shape to change when the temperature rises, each anchor (1a ) And (1b) are notches (1c1) and (1c2) having two predetermined cross-sectional shapes. ) And (1d1) (1c) and (1d2) ) Is connected to the end of the plate (1). Each anchor part (1a) (1b) is a common branch part (1e) (1f) integrated with the center connection parts (1c) (1d). Two legs (1a1) (1a2) and (1b) connected to one end via 1) (1b2).   When designing each anchor part, each leg should be The parts (1a1) (1a2) and (1b1) (1b2) are both in the front and in the arcuate plane. It is designed to deform in the plane (FIGS. 2, 5 and 6). Of each leg under the above conditions This deformation allows compression at both the plate and its end, resulting in cortical bone and And cancellous bone.   The fixing legs (1a, 1b) are made of a material defining a part of the edge of the corresponding notch. Are located at a fixed distance from the central connecting portion (1c, 1d). This bridge Means that two legs of the same pair, for example when the temperature is positive, the legs (1a) are fixed to each other Can be used to adjust the deformation force or deformation value approaching the direction of. General In addition, the desired clamping force between two legs of the same pair is two pairs of legs (1a) and (1 b) are close to each other at a certain angle and are less than the force to compress the vertebrae.   Each leg (1a1) (1a2) and (1b1) (1b2) has a blunt tip and Has a series of spikes (1 g). Plate (1) is a cross section of the front of the vertebra The lateral curvature that almost corresponds to the shape and the longitudinal curvature that matches the lordosis of the neck Have. The length of the plate (1) depends on the number of vertebrae to be fixed.   The advantages of the present invention are apparent from the above description. In particular, anchors due to the temperature rise The part is automatically deformed in both the cancellous bone part and the cortical bone part. It can be emphasized that the pressure can be maintained.   Each plate is positioned vertically with anchors at 0 ° C or negative temperature It is stored in a state that can be maintained. The plate has four legs (1a1) (1a 2) and (1b1) using four (ancillaire) receiving members (1b2) And can be easily installed. The receiving member is, for example, screwed into the passage. Alternatively, it is advantageous to fix in the slot (1h).   As shown in FIG. 1, the plate (1) has a projection (1i) between a pair of legs. can do. This projection is, for example, 5 mm long and 4 mm wide and extends parallel to the legs. And introduced between the two vertebrae during plate attachment to maintain a constant disc space, Serves to lift the intravertebral disc.   The plate is made of e.g. nickel titanium which can be deformed by shape memory properties By cutting, bending or stamping a single metal plate, Can be

───────────────────────────────────────────────────── フロントページの続き (71)出願人 トレムレ，ミシェル フランス国 31300 トゥールーズ プラ ス ドゥ ドクトゥール バラック チュ ピュルパン（番地なし) (71)出願人 ジュルダン，フィリップ フランス国 13010 マルセイユ リュ ガストン ベルジェ クリニク レジダン ス ヂュ パルク（番地なし) (71)出願人 サン ガリ，フランソワ フランス国 33000 ボルドー プラス アメリー ラバ レオン オピタル ペレ グラン（番地なし) (72)発明者 ゲラン，ジャン フランス国 33000 ボルドー プラス アメリー ラバ レオン オピタル ペレ グラン（番地なし) (72)発明者 ロベール，ロジェ フランス国 44000 ナント チュ レネ ック ヌーロシリュルジ（番地なし) (72)発明者 トレムレ，ミシェル フランス国 31300 トゥールーズ プラ ス ドゥ ドクトゥール バラック チュ ピュルパン（番地なし) (72)発明者 ジュルダン，フィリップ フランス国 13010 マルセイユ リュ ガストン ベルジェ クリニク レジダン ス ヂュ パルク（番地なし) (72)発明者 サン ガリ，フランソワ フランス国 33000 ボルドー プラス アメリー ラバ レオン オピタル ペレ グラン（番地なし) (72)発明者 グノー，ベルトラン フランス国 42300 ローヌ リュ ジョ ルジュ ドゥ カル ３────────────────────────────────────────────────── ─── Continuation of front page    (71) Applicant Tremure, Michel             France 31300 Toulouse Pula             Su de Doctur Barrack Ju               Purpan (without address) (71) Applicant Jurdan, Philip             France 13010 Marseille Ryu             Gaston Berger Clinic Residency             Sue Parc (without address) (71) Applicant Sangali, François             France 33000 Bordeaux Plus             Amery Lava Leon Opital Pele             Gran (no address) (72) Inventor Guerlain, Jean             France 33000 Bordeaux Plus             Amery Lava Leon Opital Pele             Gran (no address) (72) Inventor Robert, Roger             France 44000 Nantes-Chulene             Cuck Nuoro Sirulj (no address) (72) Inventor Tremure, Michel             France 31300 Toulouse Pula             Su de Doctur Barrack Ju               Purpan (without address) (72) Jurdan, Philip             France 13010 Marseille Ryu             Gaston Berger Clinic Residency             Sue Parc (without address) (72) Inventor Sangali, Francois             France 33000 Bordeaux Plus             Amery Lava Leon Opital Pele             Gran (no address) (72) Inventor Gnoux, Bertrand             France 42300 Rhone-Ru-Jo             Ruju de Cal 3

Claims (1)

【特許請求の範囲】 １．固定すべき椎骨内に予め形成された収容部内にほぼ垂直に導入でき、導入後 は所定角度で互いの方向に折り曲って椎骨に一定の圧迫力を加えて完全に固定す る１対のアンカー部（１ａ）（１ｂ）を各端部に有する少なくとも１つのプレー ト（１）から成ることを特徴とする少なくとも２つの椎骨を固定する器具。 ２．各プレート（１）およびそのアンカー部（１ａ）（１ｂ）が、正の温度では 所定の安定した形を取り、負の温度では別の形を取る形状記憶材料で作られてい る請求項１に記載の器具。 ３．負の温度ではアンカー部（１ａ）（１ｂ）がほぼ垂直平面内に配置され、正 の温度ではアンカー部が自動的に曲り且つ倒れる請求項１または２に記載の器具 。 ４．各対のアンカー部がプレート部分およびその端部部分の両方で圧迫され、同 一対の２つのアンカー部が抜け出るのを防ぐように締付けできるように、各アン カー部（１ａ）（１ｂ）が、アンカー部を変形できるようにするための所定断面 形状を有する２つのノッチ（１ｃ１）（１ｄ１）（１ｃ２）（１ｄ２）を規定す る中心接続部分（１ｃ）（１ｄ）を介して対応するプレートの端部に連結されて いる請求項１〜３のいづれか一項に記載の器具。 ５．アンカー部（１ａ）（１ｂ）が、中心接続部分（１ｃ）（１ｄ）の形をした 共通分岐部（１ｅ）（１ｆ）を介して１方の端部に接続された２つの脚部（１a １）（１ａ２）および（１ｂ１）（１ｂ２）から成る請求項４に記載の器具。 ６．アンカー部または脚部が材料の橋部を介して接続部分（１ｃ）（１ｄ）に接 続された請求項１〜５のいづれか一項に記載の器具。 ７．各脚部（１ａ１）（１ａ２）（１ｂ１）（１ｂ２）が内側に一連の歯付きス パイク（１ｇ）を有する請求項１〜６のいづれか一項に記載の器具。 ８．プレート（１）が椎骨の前面形状にほぼ対応する横方向湾曲度と頚部脊柱前 弯部に合った縦方向湾曲度とを有する請求項１〜７のいづれか一項に記載の器具 。 ９．プレート（１）が少なくとも１つの溝孔（１ｈ）を有する請求項１〜８のい づれか一項に記載の器具。 １０．溝孔が保護具を固定するように設計され或いはネジ切りされている請求項 ９に記載の器具。 １１．プレート（１）が固定される１対の脚部間に挿入される突起部（１ｉ）を 有する請求項１〜１０のいづれかい項に記載の器具。 １２．一枚の金属板から切り抜き、形状記憶処置をして作られた、単一部品から なる請求項１〜１１のいづれか一項に記載の器具。[Claims] 1. Can be introduced almost vertically into a preformed container in the vertebra to be fixed, Bends each other at a predetermined angle to apply a certain amount of compressive force to the vertebrae to completely fix it At least one play having a pair of anchors (1a) (1b) at each end. An instrument for fixing at least two vertebrae, comprising: 2. Each plate (1) and its anchors (1a) (1b) Made of shape memory material that takes a given stable shape and takes another shape at negative temperatures The device of claim 1. 3. At negative temperatures, the anchors (1a) (1b) are located in a substantially vertical plane and The device according to claim 1 or 2, wherein the anchor portion automatically bends and falls at a temperature of. . 4. Each pair of anchors is squeezed at both the plate and its end, Each anchor should be fastened so that the two anchors of the pair do not come off. A predetermined cross section for allowing the car parts (1a) and (1b) to deform the anchor part Two notches (1c1) (1d1) (1c2) (1d2) having a shape are defined. Connected to the ends of the corresponding plates via the central connecting portions (1c) and (1d). The device according to any one of claims 1 to 3. 5. Anchors (1a) (1b) in the form of central connecting parts (1c) (1d) Two legs (1a) connected to one end through common branches (1e) (1f) The device according to claim 4, comprising 1) (1a2) and (1b1) (1b2). 6. Anchors or legs are connected to the connecting parts (1c) (1d) via the material bridge. An instrument according to any one of the preceding claims, wherein 7. Each leg (1a1) (1a2) (1b1) (1b2) has a series of toothed The device according to any one of claims 1 to 6, comprising a pike (1 g). 8. Lateral curvature and anterior cervical spine where plate (1) roughly corresponds to the anterior shape of the vertebra An instrument according to any one of claims 1 to 7, having a longitudinal curvature adapted to the curvature. . 9. 9. The method according to claim 1, wherein the plate has at least one slot. The device according to any one of the preceding claims. 10. Claims wherein the slot is designed or threaded to secure the protective equipment An apparatus according to claim 9. 11. A projection (1i) inserted between a pair of legs to which the plate (1) is fixed The device according to any one of claims 1 to 10, comprising: 12. Cut out of a single metal plate, shape memory treated, made from a single part The device according to any one of the preceding claims.
JP10519033A 1996-10-18 1997-10-17 Device for fixing at least two vertebrae Pending JP2001502572A (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR9612951A FR2754702B1 (en) 1996-10-18 1996-10-18 DEVICE FOR SOLIDARIZING AT LEAST TWO VERTEBRAL BODIES
FR96/12951 1996-10-18
PCT/FR1997/001866 WO1998017189A1 (en) 1996-10-18 1997-10-17 Device for securing at least two vertebrae

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US (1) US6336928B1 (en)
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JP (1) JP2001502572A (en)
FR (1) FR2754702B1 (en)
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US6336928B1 (en) 2002-01-08
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FR2754702A1 (en) 1998-04-24
WO1998017189A1 (en) 1998-04-30

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